Adjustable Depth Drill Guide

ABSTRACT

The present disclosure in one aspect provides an adjustable depth drill guide comprising a trigger assembly further comprising a trigger and a primary actuating element and a telescopic rotational assembly which abuts the primary actuating element and further comprises an intermediate actuating element. The drill guide described herein allows a surgeon to adjust the depth of the drill guide using only one hand while in-situ.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.17/123,806, filed Dec. 16, 2020, which is a continuation of U.S. patentapplication Ser. No. 16/405,796, filed May 7, 2019, now U.S. Pat. No.10,898,207, which is a continuation of U.S. patent application Ser. No.15/392,896, filed Dec. 28, 2016, now U.S. Pat. No. 10,327,787, whichclaims priority to U.S. provisional patent application No. 62/271,719,filed Dec. 28, 2015, each of which is incorporated by reference in itsentirely herein.

FIELD

The field of the invention generally relates to adjustable depth drillguides for medical instruments for use in surgical applicationsrequiring precision depth adjustment.

BACKGROUND

Drill guides are often used to assist surgeons in creating a pilot holeprior to screw insertion as the drill guides allow greater precision andcontrol while creating the pilot hole. During posterior cervicalsurgical procedures, for example, drill guides are used to assist thesurgeon setting the depth of the pilot hole, based on the length of thescrew, to ensure the hole is drilled at the proper depth. Typically,this often requires that the surgeon estimate the appropriate length forthe screw, preset the guide to the appropriate depth based on the bonescrew size estimation, place the guide in the surgical opening, andfinally drill the pilot hole. Subsequently, the surgeon may take aseries of real-time X-rays to determine if the pilot hole depth issufficient. If it is not, the surgeon must remove the drill guide, resetthe drill guide to the appropriate length, and reintroduce theinstrument to the surgical wound or opening. This can be time-consuming,creates numerous opportunities for error, and increases the risk ofinfection.

In order to make real-time adjustments without removing the drill guidefrom the surgical opening, surgeons must be afforded the luxury of usinga drill guide that requires the use of only one hand to make anynecessary incremental adjustments to increase hole depth. As the drillguide is operable by using only one hand, instead of two as described inprior art, the surgeon is able to adjust the depth of the drill guidewith one hand while maintaining the drill in the other hand. This isimportant as it prevents the necessity of removing the drill guide fromthe surgical opening and the instrument can remain in-situ. The drillguide described herein allows the surgeon to introduce the drill guideinto the surgical area and adjust the depth as necessary with onesqueeze of the trigger, thus, addressing the need to make real-timeadjustments within the surgical area.

SUMMARY

Disclosed herein is a drill guide for use in surgery. In one embodiment,an adjustable depth drill guide is provided comprising a shell, atrigger assembly, and a telescopic rotational assembly. The shell of thedrill guide is comprised of a handle, a frame, a drill stop, and ashaft. Enclosed in the shell of the drill guide is first, the triggerassembly, comprised of a primary actuating element, a trigger, and adistal spring. Finally, the drill guide includes a telescopic rotationalassembly, comprised of an inner guide, a sheath, an intermediateactuating element, and a proximal spring.

The drill guide has a proximal and distal end. A frame is attached tothe upper portion of the handle and extends horizontally along thelength of the device, ultimately forming a vertical member with anopening. Additionally, the shaft and drill stop combine with the handleand frame to form the shell of the drill guide, enclosing the triggerassembly and telescopic rotational assembly.

Upon pulling the trigger, the primary actuating element begins totranslate proximally toward the intermediate actuating element. Thetranslation of the primary actuating element in turn causes theintermediate actuating element to translate proximally toward theproximal end of the drill guide within the sheath. Once the intermediateactuating element reaches a certain point, the intermediate actuatingelement rotates 180 degrees. This rotation causes the sheath to rotateclockwise along the inner guide. The rotation of the sheath results inthe sheath translating toward the distal portion of the drill guide anincremental distance and thus, the drill stop translates an identicaldistance. The surgeon may reverse this action by rotating the drill stopcounter-clockwise. This counter-clockwise rotation reverses the rotationof the sheath and intermediate actuating element, reducing the depth ofthe drill guide an incremental distance. The surgeon can repeat eitheraction within the bounds of the drill guide, with one hand, and withoutmoving the drill guide from the surgical area.

According to another embodiment, an adjustable depth drill guide isdescribed. The drill guide is also fitted with a modular sleeve that maybe affixed to the vertical element of the frame.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a side view of one embodiment of the drill guide ofthe present disclosure.

FIG. 2A illustrates a side view of one embodiment of the drill guidewithout the shaft and sheath so as to view the inner guide, the distaland proximal springs, the primary actuating element and the intermediateactuating element.

FIG. 2B illustrates the same elements of FIG. 2A; however, with theaddition of illustrative arrows to show direction of movement once atrigger cycle is initiated.

FIG. 3 illustrates a side view of the shell of one embodiment of thedrill guide.

FIG. 4A illustrates a top view of the frame as described in oneembodiment of the drill guide of the present disclosure.

FIG. 4B illustrates a side view of the frame as described in oneembodiment of the drill guide of the present disclosure.

FIG. 4C illustrates an isometric view of the frame as described in oneembodiment of the drill guide of the present disclosure.

FIG. 4D illustrates a cross sectional view of the frame as described inone embodiment of the drill guide of the present disclosure.

FIG. 5 shows a side view of the trigger assembly of one embodiment ofthe drill guide.

FIG. 6A illustrates an isometric view of the trigger and primaryactuating element as described in one embodiment of the drill guide ofthe present disclosure.

FIG. 6B illustrates a side view of the trigger and primary actuatingelement as described in one embodiment of the drill guide of the presentdisclosure.

FIG. 7A illustrates an isometric view of the drill stop as described inone embodiment of the drill guide of the present disclosure.

FIG. 7B illustrates a side view of the drill stop guide as described inone embodiment of the drill guide of the present disclosure.

FIG. 8 illustrates a cross sectional view of the sheath, inner guide,proximal spring and intermediate actuating element as described in oneembodiment of the drill guide of the present disclosure.

FIG. 9 illustrates a side view of the inner guide as described in oneembodiment of the drill guide of the present disclosure.

FIG. 10A illustrates a front view of the sheath as described in oneembodiment of the drill guide of the present disclosure.

FIG. 10B illustrates an isometric view of the sheath from the proximalend as described in one embodiment of the drill guide of the presentdisclosure.

FIG. 10C illustrates an isometric view of the sheath from the distal endas described in one embodiment of the drill guide of the presentdisclosure.

FIG. 11A illustrates a view of the intermediate actuating element fromthe proximal end as described in one embodiment of the drill guide ofthe present disclosure.

FIG. 11B illustrates a side view of the intermediate actuating elementas described in one embodiment of the drill guide of the presentdisclosure.

FIG. 11C illustrates an isometric view of the intermediate actuatingelement as described in one embodiment of the drill guide of the presentdisclosure.

FIG. 12 illustrates a cross sectional side view of an alternativeembodiment of the drill guide of the present disclosure.

DETAILED DESCRIPTION

Unless otherwise defined, all terms (including technical and scientificterms) used herein have the same meaning as commonly understood by oneof ordinary skill in the art of this disclosure. It will be furtherunderstood that terms, such as those defined in commonly useddictionaries, should be interpreted as having a meaning that isconsistent with their meaning in the context of the specification andshould not be interpreted in an idealized or overly formal sense unlessexpressly so defined herein. Well known functions or constructions maynot be described in detail for brevity or clarity.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting. As used herein, thesingular forms “a”, “an” and “the” are intended to include the pluralforms as well, unless the context clearly indicates otherwise.

Spatially relative terms, such as “under”, “below”, “lower”, “over”,“upper” and the like, may be used herein for ease of description todescribe one element or feature's relationship to another when theapparatus is right side up.

The terms “about” and “approximately” shall generally mean an acceptabledegree of error or variation for the quantity measured given the natureor precision of the measurements. Typically, exemplary degrees of erroror variation are within 20 percent (%), preferably within 10%, and morepreferably within 5% of a given value or range of values. Numericalquantities given herein are approximate unless stated otherwise, meaningthat the term “about” or “approximately” can be inferred when notexpressly stated.

Illustrative embodiments of the invention are described below. In theinterest of clarity, not all features of an actual implementation aredescribed in this specification. It will of course be appreciated thatin the development of any such actual embodiment, numerousimplementation-specific decisions must be made to achieve thedevelopers' specific goals, such as compliance with system-related andbusiness-related constraints, which will vary from one implementation toanother. Moreover, it will be appreciated that such a development effortmight be complex and time-consuming, but would nevertheless be a routineundertaking for those of ordinary skill in the art having the benefit ofthis disclosure.

While the subject matter is susceptible to various modifications andalternative forms, specific embodiments thereof have been shown by wayof example in the drawings and are herein described in detail. It shouldbe understood, however, that the description herein of specificembodiments is not intended to limit the subject matter to theparticular forms disclosed, but on the contrary, the subject matter isto cover all modifications, equivalents, and alternatives falling withinthe spirit and scope of the subject matter as defined herein. Forexample, any of the features of a particular example described hereinmay be used with any other example described herein without departingfrom the scope of the present subject matter.

The present disclosure provides an adjustable depth drill guide 1000that allows surgeons to make incremental depth adjustments in smallincrements when drilling pilot holes prior to bone screw placement. Inthe embodiment shown in FIGS. 1-3, 5, and 8 , the adjustable depth drillguide 1000 comprises: a shell 1200, a trigger assembly 1500, and atelescopic rotational assembly 1600.

The shell 1200 of the drill guide 1000 is comprised of a handle 600, aframe 100, a drill stop 400, and a shaft 200. As shown in FIG. 3 theshell 1200 provides the outer shape of the drill guide 1000. The handle600 provides a hand-hold for the surgeon and allows the surgeon tonavigate the drill guide 1000 and guide it into the proper space.Immediately above and connected to the upper portion of the handle 600is the frame 100.

The frame 100 is comprised of a generally horizontal portion 116extending from the top portion of the handle 600 laterally toward thedistal end 120 of the drill guide 1000. As illustrated in FIGS. 4A-D,the horizontal portion has a length 106, width 109, and height 112. Theheight 112 and length 106, are sized to accommodate the trigger 500.Likewise, the width 109 must also be a sufficient distance so as toaccommodate the dimensions of the trigger 500.

The horizontal portion 116 of the frame 100 has an opening 103 thatextends through the horizontal portion 116 and receives trigger 500.Additionally, the opening 103 must have a length sufficient toaccommodate the lateral translation of the trigger 500 so that onetrigger cycle (as discussed below) can be completed. Furthermore,located on the distal end 120 of the horizontal portion 116 of the frame100 is the vertical element 115 of the frame 100. As shown in FIGS. 4Aand 4B, the vertical element 115 includes a height 111, a width 107 anda thickness 108. As shown in FIGS. 4C and 4D, the vertical element 115has a height 111 that is sufficient to include a distal opening 105. Thedistal opening 105 extends partially through the thickness 108 of thevertical element 115. The distal opening 105 has a diameter that willvary in size, but may coincide with the diameter a modular sheath 300 inalternative embodiments (as discussed below). Furthermore, the distalopening 105 may be fitted with a female thread 104 that allows theconnection of the modular sheath 300 (as discussed below). Additionally,located on the opposite end of the vertical element 115 is the proximalopening 113. The proximal opening 113 has a diameter that will vary insize, but must coincide with the diameter of the inner guide 900.

In this embodiment, the shell 1200 also includes a shaft 200. Asillustrated in FIG. 3 , the shaft 200 is a hollow cylinder that islocated adjacent to the vertical element 115 of the frame 100. The shaft200 surrounds a number of internal elements (as discussed below).Additionally, the shaft 200 has a diameter that is sufficient to receivethe sheath 300 upon lateral translation of the sheath 300 toward thedistal end 1120 of the drill guide 1000.

The shell 1200 of this drill guide 1000 includes a drill stop 400. Thedrill stop 400 serves two primary purposes: 1) it provides a barrier forthe drill to prevent plunging during use; and 2) allows the surgeon toreverse the depth by rotating the drill stop 400, and in turn the sheath300, counter-clockwise. As illustrated in FIGS. 1, 2A, 2B, 3, 7 A and7B, the drill stop 400 is located on immediately adjacent to theproximal end 310 of the sheath 300. The drill stop 400 may encompass aportion of the sheath 300 in its static state as shown in FIGS. 1 and 3. The drill stop 400 also includes an opening 401 which allows thesurgeon to insert the drill through the drill stop 400.

Enclosed in the shell 1200 of the drill guide 1000 is first, the triggerassembly 1500, comprised of a primary actuating element 700, a trigger500, and a distal spring 102. According to the exemplary embodimentshown in FIGS. 5-6B, the trigger 500 and primary actuating element 700are of unitary construction. As illustrated in FIGS. 1-2A, 5, 6A, and6B, the trigger 500 is located immediately below the primary actuatingelement 700 and may be perpendicular to the primary actuating element700. The primary purpose of the trigger 500 is to translate the primaryactuating element 700 laterally toward the proximal end 1110 of thedrill guide 1000 as shown in FIG. 2B. This is accomplished when thesurgeon squeezes or pulls the trigger 500 toward the handle 600.

The primary actuating element 700 is a hollow cylinder. Located on theproximal end 710 of the primary actuating element 700 is a recess 701designed to receive the control pin 902 once the primary actuatingelement 700 translates laterally toward the proximal end 1110 of thedrill guide 1000. This recess 701 is large enough to accept the controlpin 902 during translation of the primary actuating element 700 upon theinitiation of the first trigger cycle.

Additionally, as illustrated in FIG. 3 , trigger assembly 1500 includesa distal spring 102 located toward the distal end 1120 of the drillguide 1000 and is located on the exterior of the primary actuatingelement 700. The distal spring 102 is attached to both the frame 100,and the primary actuating element 700. The distal spring 102 is designedto shore up any slack that may exist, but also assists in returning theprimary actuating element 700 and trigger 500 in its resting location.

Finally, the drill guide 1000 also includes a telescopic rotationalassembly 1600, illustrated in FIG. 8 , comprised of an inner guide 900,a sheath 300, an intermediate actuating element 800, and a proximalspring 101. The telescopic rotational assembly 1600 is responsible forinitiating the final step, ultimately responsible for depth adjustment.

The inner guide 900 serves the purpose of guiding the drill bitthroughout the drill guide 1000. As illustrated in FIGS. 2A, 2B, 8, and9 , the inner guide 900 is a narrow cylinder with an opening 903 thatextends throughout the length of the inner guide 900. The inner guide900, itself, runs nearly the length of the shell 1200 of the drill guide1000, beginning at the proximal end 310 of the sheath 300 and continuingthroughout the drill guide 1000 into the vertical element 115 of theframe 100. Located on the proximal end 910 of the inner guide 900 ismale threaded portion 901 which is threaded to the female threadedportion 302 of the sheath 300. Furthermore, located approximately midwayon the inner guide 900 is a pair of control pins 902. The control pins902 are placed in the slots 805 between the two arms 804 of theintermediate actuating element 800 and prevents rotation once the drillguide 1000 begins a trigger cycle.

In this embodiment, the telescopic rotational assembly 1600 alsoincludes a sheath 300. The sheath 300, like the shaft 200, is also ahollow cylinder. As illustrated in FIGS. 8, 10A-C, located on the innercircumference of the sheath 300 at the distal end 320 of the sheath 300is a pair of female rail slots 301 directly across from each other. Thefemale rail slots 301 are a distance long enough to receive the malerails 801 of the intermediate actuating element 800 upon translationtoward the proximal end 1110 of the drill guide 1000. Furthermore,located on the proximal end 310 of the sheath 300 is a female threadedportion 302. This threaded portion 302 interacts with the male threadedportion 901 of the inner guide 900 and allows the sheath 300 as a whole,to rotate and move within the shaft 200 to regulate and adjust the depthof the drill.

In addition to the aforementioned parts, the telescopic rotationalassembly 1600 also contains an intermediate actuating element 800 whichis adjacent to the primary actuating element 700. As illustrated inFIGS. 2A, 2B, 8, and 11A-C, the intermediate actuating element 800 is ahollow cylinder with two distinct arms 804 located on the distal end 820of the intermediate actuating element 800. Located between the two arms804 is a slot 805 large enough for the control pin 902 to rest prior toinitiating a trigger cycle. Each arm 804 is configured so that each arm804 has a spiraled, ramped portion 802 and a straightened portion 803.The two arms 804 are aligned so that the ramped, spiraled portion 802 ofone arm 804, is adjacent to the straightened portion 803 of the arms804, so that a slot 805 is formed between the spiraled portion 802 andthe straightened portion 803 of the arms 804 and the control pin 902 mayrest therein prior to the initiation of one trigger cycle.

Furthermore, located on the proximal end 810 of the intermediateactuating element 800 is a pair of male rails 801. These rails 801 areslidingly engaged with the female rail slots 301 located on the sheath300. Upon lateral translation of the intermediate actuating element 800toward the proximal end 1110 of the drill guide 1000, the rails 801slide within the female rail slots 301 of the sheath 300.

Finally, the telescopic rotational assembly contains a proximal spring101. The proximal spring 101 is located near the proximal end 1110 ofthe drill guide 1000 and wraps around the exterior of a portion of theinner guide 900. The proximal spring 101 is attached to both the innerguide 900 and the interior of the intermediate actuating element 800.Like the distal spring 102, the proximal spring 101 assists in returningthe intermediate actuating element 800 to its resting position.

With regards to this embodiment, the drill guide 1000 is assembled asfollows. The handle 600 is attached to the lower portion 116 of theproximal end 110 of the frame 100. The primary actuating element 700 isimmediately adjacent to the vertical element 115 of the frame 100.Furthermore, the trigger 500, extends from the proximal end 710 of theprimary actuating element 700 through the opening 103 of the frame 100.The trigger 500 is substantially parallel to the handle 600. The distalspring 102 wraps around the primary actuating element 700 and connectsto both primary actuating element 700 and the vertical element 115 ofthe frame 100.

Immediately adjacent to the proximal end 710 of primary actuatingelement 700, is the intermediate actuating element 800. Prior toinitiating a trigger cycle, the proximal end 710 of the primaryactuating element 700 rests against the arms 804 of the intermediateactuating element 800 located on the distal end 820 of the intermediateactuating element 800. Furthermore, the intermediate actuating element800 is partially covered by the adjacent sheath 300. The intermediateactuating element 800 fits within the sheath 300 via the male rails 801which correspond with the female rail slots 301 of the sheath 300.

The intermediate actuating element 800, the primary actuating element700, and the proximal spring 101 are all fully enclosed within the shaft200. Located on the proximal end 310 of the sheath 300, is the drillstop 400. The drill stop 400 partially covers the proximal end 310 ofthe sheath 300. Beginning within the female threaded portion 302 of thesheath 300, is the male threaded portion 901 of the inner guide 900. Theinner guide 900 then extends through the sheath 300, the opening of theintermediate actuating element 800 at the proximal end 810 and extendingtherethrough the distal end 820. Located on the inner guide 900 betweenthe two arms 804 of the intermediate actuating element 800 are twocontrol pins 902. The inner guide 900 continues through the opening ofthe primary actuating element 700, coming to a stop in the proximalopening 105 of the vertical element 115 of the frame 100.

With regards to the embodiment shown in FIG. 1 , the drill guide 1000 isset to the initial depth prior to insertion into the surgical area. Thisis determined based on the surgeon's initial assessment and estimate ofthe appropriate bone screw length. The surgeon may then insert the drillthrough the drill stop 400 and the inner guide 900 wherein the drillwill exit through the vertical element 115 of the frame 100. At thistime, the surgeon may ascertain that the first pilot hole is not of asufficient depth, and thus, requires a small, incremental adjustment. Atthis point, the surgeon may pull the trigger 500 of the drill guide 1000once to complete one trigger cycle and thus, increase the depth of thedrill.

Upon pulling the trigger 500 toward the handle 600, a series of eventswill occur before this trigger cycle is complete. First, the primaryactuating element 700 will translate laterally toward the proximal end1110 of the drill guide 1000. This action expands the distal spring 102.As the primary actuating element 700 translates toward the proximal end1110 of the drill guide 1000, it simultaneously begins to translate theintermediate actuating element 800. In its static state, thestraightened portion 803 of the arm 804 of the intermediate actuatingelement 800 rests against the control pins 902 located on the innerguide 900. The control pins 902, in combination with the straightenedportion 803 of the arm 804, prevent premature rotation of theintermediate actuating element 800. Concurrently, the intermediateactuating element 800, via the male rail 801 located on the intermediateactuating element 800, slides within the female rail slot 301 of thesheath 300 during this translation. Additionally, translation of theintermediate actuating element 800 compresses the proximal spring 101.

Next, the primary actuating element 700, along with the intermediateactuating element 800, continue to translate to the proximal end 1110 ofthe drill guide 1000 until the control pin 902 no longer obstructs therotation of the intermediate actuating element 800. Once theintermediate actuating element 800 translates past the control pins 902,and the control pins 902 clear the arm 804 of the intermediate actuatingelement 800, the control pins 902 will move into the recess 701 of theprimary actuating element. At this point, the intermediate actuatingelement 800 is now partially covered by the sheath 300. Subsequently,the intermediate actuating element 800 will rotate 180.degree.clockwise. Simultaneously, the sheath 300 will also rotate clockwise.

Upon rotation of the intermediate actuating element 800, and in turn thesheath 300, the female threaded portion 302 of the sheath 300, interactswith the male threading 901 of the inner guide 900. The threading 302 ofthe sheath 300 will rotate along the threading 901 of the inner guide900. This rotation will cause the sheath 300 to translate forward anincremental distance based on the pitch of the threading, telescopicallyinto the shaft 200. As the drill stop 400 is attached to the sheath 300,the drill stop 400 also translates toward the distal end of the drillguide 1000, allowing the surgeon to drill deeper. For purposes of thisembodiment, the incremental distance is 1 mm. The surgeon will hear a“click” to signal that the trigger cycle is complete.

Upon completion of one trigger cycle and release of the trigger 500, thecompressed proximal spring 101, exerts force in the direction of thedistal end 1120 of the drill guide 1000. Simultaneously, the distalspring 102 returns to its static state. These simultaneous actions, incombination with the control pins 902, prevent multiple, unintendedrotations of the intermediate actuating element 800. As a result, theintermediate actuating element 800 and the primary actuating element 700return to their original locations. The surgeon is free to repeat theaforementioned actions as needed to reach the appropriate depth.

The drill guide 1000 also allows the surgeon to reverse the adjustment.This is accomplished when the surgeon rotates the drill guide stop 400in the counter-clockwise direction. The counter-clockwise rotation ofthe drill stop guide 400 rotates the sheath 300, and in turn, theintermediate actuating element 800 counter-clockwise. During thiscounter-clockwise rotation, the control pins 902, slide up the spiralramps 802 of the intermediate actuating element 800. The rotation of thesheath 300 interacts with the inner guide 900 and translates the sheath300 proximally. As a result, the drilling depth is decreased anincremental amount. Similar to the clockwise rotation, the surgeon willhear a click once the control pins 902 reach the end of the spiral andpop into the adjacent slot 805 to signal that one reverse trigger cycleis complete.

Additional embodiments of the present disclosure describe an adjustabledepth drill guide 2000 that is configured for allowing surgeons to makeincremental depth adjustments in small increments when drilling pilotholes prior to bone screw placement. The adjustable depth drill guide2000 as illustrated in FIG. 12 comprises: a handle 2600; an inner guide2900; a modular sleeve 1300; a sheath 2300; an intermediate actuatingelement 2800; a primary actuating element 2700; a trigger 2500; a drillstop 2400; a frame 2100; a shaft 2200; a plurality of control pins 2902;and a proximal spring 2101; and a distal spring 2102.

The configuration of this embodiment is identical to that of theoriginal except the addition of the modular sleeve 1300. The modularsleeve 1300 contains a threaded portion 1301. This threaded portion 1301may be affixed to the frame 100 via the distal opening 105 of thevertical element 115 of the frame 100. The distal opening 105 isthreaded 104 so that the modular sleeve 1300 may be affixed to the drillguide 1000. The addition of the modular sleeve 1300 allows the surgeonto drill at various angles. Further, the modular sleeve 1300 can beconfigured to mate with various implants or anatomy. The modular sleeve1300, similar to the inner guide 900 is a hollow cylinder with anopening 1302 that extends throughout the length of the modular sleeve1300.

Although this invention has been disclosed in the context of certainpreferred embodiments and examples, it will be understood by thoseskilled in the art that the present invention extends beyond thespecifically disclosed embodiments to other alternative embodimentsand/or uses of the invention and obvious modifications and equivalentsthereof. In addition, while a number of variations of the invention havebeen shown and described in detail, other modifications, which arewithin the scope of this invention, will be readily apparent to those ofskill in the art based upon this disclosure. It is also contemplatedthat various combinations or sub-combinations of the specific featuresand aspects of the embodiments may be made and still fall within thescope of the invention. Accordingly, it should be understood thatvarious features and aspects of the disclosed embodiments can becombined with or substituted for one another in order to form varyingmodes of the disclosed invention. Thus, it is intended that the scope ofthe present invention herein disclosed should not be limited by theparticular disclosed embodiments described above, but should bedetermined only by a fair reading of the claims that follow.

Similarly, this method of disclosure is not to be interpreted asreflecting an intention that any claim require more features than areexpressly recited in that claim. Rather, as the following claimsreflect, inventive aspects lie in a combination of fewer than allfeatures of any single foregoing disclosed embodiment. Thus, the claimsfollowing the Detailed Description are hereby expressly incorporatedinto this Detailed Description, with each claim standing on its own as aseparate embodiment.

What is claimed is:
 1. A drill guide for drilling a hole within a surgical opening, the drill guide comprising: a trigger; a primary actuating element coupled to the trigger; and an intermediate actuating element adjacent to the primary actuating element, wherein the intermediate actuating element is configured to rotate in response to actuation of the trigger.
 2. The drill guide of claim 1, further comprising a sheath coupled to the intermediate actuating element.
 3. The drill guide of claim 2, wherein the sheath comprises a rail slot configured to slidably receive a rail of the intermediate actuating element.
 4. The drill guide of claim 2, wherein the sheath is configured to translate distally relative to the drill guide in response to rotation of the intermediate actuating element.
 5. The drill guide of claim 4, further comprising a drill stop coupled to the sheath and configured to translate distally relative to the drill guide in response to translation of the sheath, wherein the drill stop comprises an opening to allow a drill to be inserted therethrough.
 6. The drill guide of claim 5, wherein the drill stop is configured to allow a user to reduce a depth to which the drill is inserted by rotating the drill stop.
 7. The drill guide of claim 2, further comprising an inner guide threadedly coupled to the sheath.
 8. The drill guide of claim 7, further comprising a proximal spring wrapped around an exterior surface of a portion of the inner guide and positioned adjacent to a proximal end of the drill guide.
 9. The drill guide of claim 7, wherein the intermediate actuating element is configured to rotate about the inner guide.
 10. The drill guide of claim 9, wherein an angle of rotation of the intermediate actuating element is about 180 degrees.
 11. The drill guide of claim 7, wherein the intermediate actuating element comprises two arms positioned on a distal end thereof.
 12. The drill guide of claim 11, wherein each of the two arms includes a ramped portion and a straight portion.
 13. The drill guide of claim 11, wherein the inner guide comprises a control pin configured to be received in a slot between the two arms of the intermediate actuating element.
 14. The drill guide of claim 13, wherein the primary actuating element further comprises a recess sized to receive the control pin in response to proximal translation of the primary actuating element relative to the drill guide.
 15. The drill guide of claim 2, wherein actuation of the trigger causes translation of the primary actuating element proximally relative to the drill guide, thereby causing rotation of the intermediate actuating element and rotation of the sheath.
 16. The drill guide of claim 15, wherein rotation of the sheath causes the sheath to translate distally relative to the drill guide, thereby increasing a drilling depth of the drill guide.
 17. The drill guide of claim 1, wherein the trigger is configured to be actuated by only one hand of a user.
 18. The drill guide of claim 17, wherein the trigger is configured to be actuated without removing the drill guide from the surgical area.
 19. The drill guide of claim 1, further comprising a distal spring wrapped around the primary actuating element.
 20. The drill guide of claim 19, wherein the distal spring is configured to expand in response to proximal translation of the primary actuating element upon actuation of the trigger. 